We're governed less by professional politicians than we think

By Paul Goodman
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The combination of Eastleigh and Italy have between them unleashed a tidal wave of commentary about the drawbacks of being governed by the professional politics.  Consider Charles Moore's column in today's Daily Telegraph:

"Eastleigh brings out something which more and more voters feel. A quarter of a century ago, when people used to complain in pubs that “they’re all the same”, I used to argue back: it seemed to me patently false. Today, I stay quiet. Nigel Farage says that we have three social democrat parties now. There is a bit of truth in that, but I would put it differently. It is not so much that they all think the same thing. It is more that they are all the same sort of people. They all belong to a political elite whose attitudes and careers are pretty different from those of the rest of us."

Even the briefest inspection of David Cameron and Ed Miliband supports this view.  Miliband has been a full-time political apparatchick since University.  Cameron briefly had a job in television, but not a career: the post was acknowledged to be a waiting room for the Commons, even by his employers.

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Conservatives dominate the top 20 most mentioned politicians of 2012

By Matthew Barrett
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The annual newspaper index report by Hanover Communications into media coverage of MPs shows that 12 of the top 20 most-mentioned politicians are Conservatives. The index, which measures newspaper coverage over the last year, shows few Labour frontbenchers have media profiles, with only Ed Balls and Ed Miliband featuring in the list.

I list below the top twenty politicians and the number of mentions they received:

• David Cameron - 18384
• George Osborne - 9531
• Ed Miliband - 6211
• Nick Clegg - 6155
• Boris Johnson - 3320
• Michael Gove - 2844
• Tony Blair - 2694
• Gordon Brown - 2387
• Ed Balls - 2201
• Vincent Cable - 2061
• Theresa May - 1743
• Andrew Lansley - 1621
• William Hague - 1580
• Jeremy Hunt - 1525
• John Major - 960
• Ken Livingstone - 861
• Andrew Mitchell - 858
• Nadine Dorries - 857
• Iain Duncan Smith - 857
• Ed Davey - 823

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Andrew Lansley and Sir George Young take office with light legislative schedule

By Matthew Barrett
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Parliament is properly back, and Conservative MPs can now get used to Andrew Lansley, the new Leader of the House of Commons, and Sir George Young, the new Chief Whip. Sir George was a fine Leader of the House, and managed to fit plenty of opposition and backbench debates into the parliamentary calender, as well as dealing with this Government's legislation. One hopes Mr Lansley continues in the same vein. The Government Bills currently in front of the Commons are:

• European Union (Croation Accession and Irish Protocol) Bill 2012-13
• Groceries Code Adjudicator Bill 2012-13
• Growth and Infrastructure Bill 2012-13
• Local Government Finance Bill 2010-12 to 2012-13
• Public Service Pensions Bill 2012-13
• Small Charitable Donations Bill 2012-13

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Full post-reshuffle list of Ministers

By Matthew Barrett
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Following on from the last few days' rolling blogs, I have below a final list of the MPs (and Baroness Warsi) appointed as Ministers for each department. I have put new appointments in bold.

Cabinet Office

• Minister for the Cabinet Office, Paymaster General – Rt Hon Francis Maude MP
• Minister for Government Policy – Rt Hon Oliver Letwin MP
• Minister of State – Rt Hon David Laws MP (jointly with the Department for Education)
• Parliamentary Secretary – Nick Hurd MP
• Parliamentary Secretary – Chloe Smith MP

Department for Business, Innovation and Skills

• Secretary of State for Business, Innovation and Skills; and President of the Board of Trade – Rt Hon Dr Vincent Cable MP
• Minister of State (Universities and Science) – Rt Hon David Willetts MP
• Minister of State – Michael Fallon MP
• Parliamentary Under Secretary of State – Jo Swinson MP
• Parliamentary Under Secretary of State – Matthew Hancock MP (jointly
• with the Department for Education)

Department for Communities and Local Government

• Secretary of State for Communities and Local Government – Rt Hon Eric Pickles MP
• Senior Minister of State (Faith and Communities) – Rt Hon Baroness Warsi (jointly with the Foreign and Commonwealth Office)
• Minister of State (Housing) – Mark Prisk MP
• Parliamentary Under Secretary of State (Planning) - Nicholas Boles MP
• Parliamentary Under Secretary of State – Rt Hon Don Foster MP
• Parliamentary Under Secretary of State – Brandon Lewis MP

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34 Conservative MPs write to Andrew Lansley to express "serious concerns" about plain tobacco packaging

By Matthew Barrett
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On Friday, 50 MPs, including 34 Conservatives, wrote a letter to the Health Secretary, Andrew Lansley, expressing their "serious concerns" with the Department of Health’s proposal to introduce plain packaging for tobacco products.

The letter stated that:

"There is no reliable evidence that plain packaging will have any public health benefit; no country in the world has yet to introduce it. However, such a measure could have extremely negative consequences elsewhere. The proposal will be a smuggler’s charter. ... this policy threatens more than 5,500 jobs directly employed by the UK tobacco sector, and over 65,000 valued jobs in the associated supply chain. ... Given the continued difficult economic climate, businesses should not be subjected to further red tape and regulation"

The signatories of the letter also expressed concern about the freedom aspect of blocking any branding of tobacco products:

"...we believe products must be afforded certain basic commercial freedoms. The forcible removal of branding would infringe fundamental legal rights, severely damage principles around intellectual property and set a dangerous precedent for the future of commercial free speech. Indeed, if the Department of Health were to introduce standardised packaging for tobacco products, would it also do the same for alcohol, fast food, chocolate and all other products deemed unhealthy for us?"

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Andrew Lansley sets out strategy to improve public health and reduce health inequalities

Tim Montgomerie

Highlights of Mr Lansley's statement are pasted below:

Labour's legacy: "Britain currently has amongst the highest rates of obesity and sexually transmitted infections in Europe. Smoking still claims 80,000 lives a year. Alcohol related admission to hospital are unacceptably high. And in recent years, inequalities in health have widened, rather than narrowed."

Healthier living isn't largely about healthcare... "About a third of all cases of circulatory disease, half of all cases of vascular dementia and many cancers could be avoided by reducing smoking, improving diet and increasing physical activity. We need to do better, and we won’t make progress if public health continues to be seen just in terms of NHS provision and of state interventions. Two-thirds of our potential impact on life expectancy depends on issues outside health care."

...it's about family, welfare and transport: "For instance, because we know a mother’s health is key to a child’s health and development, we are investing in Sure Start Children’s Centres and 4,200 more health visitors to give families the support they need. Because we know those who are unemployed for long periods are more likely to be admitted to hospital and more likely to die prematurely, we’re transforming the welfare system, ending the benefits trap, and making sure that work always pays through a single Universal credit. And because we know more people would cycle to work or school more often if there were safer routes for them to use, The Government are investing £560 million in sustainable transport."

Unhealthy lifestyles are costly to the taxpayer: "Alcohol abuse costs us an estimated £2.7 billion and obesity costs an extra £4.2 billion each year to the NHS alone."

Government should help people to healthier lifestyles, not order them to adopt them: "It’s time for politicians to stop telling people to make healthy choices, and time to start actually helping them to do it. Rather than nannying people, we will nudge them by working with industry to make healthy lifestyles easier. Rather than lecturing people about their habits, we will give them the support they need to make their own choices."

Local councils will take the lead on public health: "Under this White Paper, the lead responsibility for improving health will pass to local government for the first time in 40 years. We intend to give local authorities new powers to plan, co-ordinate and deliver local strategies with the NHS and other partners and to embed the foundations of good health in ways that fit local circumstances."

Public health budgets will now be protected: "Public health budgets were constantly raided by other parts of the NHS, we will prioritise public health spending through a new ring-fenced budget."

Andrew Lansley criticises Labour for conflicting advice on swine flu and the delayed launch of national pandemic flu line

Andrew Lansley, Shadow Secretary of State for Health: "Over the weekend, conflicting advice was issued to expectant mothers. Consistent and accurate advice is paramount in a situation in which we are trying to maintain public confidence, so can the Secretary of State tell the House what steps he is taking to ensure that the chief medical officer liaises with the royal colleges and other associations to achieve consistency and clarity of advice to the public?

An interim solution for the national pandemic flu line is to be put in place. We know that the Treasury delayed until December signing the contract for a full solution with BT. Even so, this March, the Secretary of State’s Department said that it could be available by April or May. It should, according to the plan, have been activated in mid-June, when the pandemic alert was declared, but it was not. To that extent, it is a month late. It is clear that much of the confusion that we have seen in that month could have been avoided if the Government had delivered the pandemic flu line on time. BT says that it did all that was asked of it. Who and what caused the delay?

...We know that the UK has the smallest number of critical care beds in relation to population of any major health system. May I ask the Secretary of State again what criteria he thinks should be applied to the cancellation of elective operations, and what plans the Government have to train additional NHS staff in the use of non-invasive ventilatory support?"

Andy Burnham MP, Health Secretary: "The hon. Gentleman asked me about the advice for pregnant mothers, which he said was confusing. Let me say again that our advice has not changed. I cannot make that clear enough. The front page of a newspaper stated that one voluntary body had said that people should not plan for a pregnancy—should postpone pregnancy, in effect—and there was a response to that from the Royal College of General Practitioners. I would be grateful if he would listen to this point: comment has been made on the advice prepared a long time ago for H5N1, bird flu, which, as I think he knows, would have been a more serious virus. It is important that care is taken to ensure that the statements that are made relate to the current advice. As I say, that advice has not changed.

The Royal College of General Practitioners and the Royal College of Obstetricians and Gynaecologists have played a superb role over the past few weeks, and I am sure that they will continue to do so. Both organisations have given clear advice today and in the past week, and of course we will continue to liaise with them to ensure that they can continue to play that role.

The hon. Gentleman said that the national pandemic flu service was “a month late”, and asked who had caused the delays. This brings us to the heart of some of the information that the Liberal Democrats were putting out this weekend. I am afraid that they were trying to score a political point when none was justified. As I have explained, when I came into the Department, the clear advice to me was that it would be justified to stand up a new national network—with all the resource, energy and time that that would take—when we had simultaneous outbreaks in many parts of the country and there was not only pressure in two or three places but more sustained pressure across the country.

I want to refer the hon. Gentleman back to the numbers that I quoted in my statement. I will read them to him again, because they illuminate this point. I said: “On 8 July, just six primary care trusts reported exceptional levels of flu-like illness.” One week later, that figure had increased to 110. On that day, 15 July, I took the decision—which was endorsed by Cobra—to activate the national pandemic flu service. We could have done it earlier, had the circumstances justified that. I have been clear since I came into the Department that the service could have been activated, should that have proved necessary. The change in the facts on the ground last week justified the activation of the service, and I do not believe that it is right to build a story about long delays and infighting. That has not been the case, and the decision was not technology-driven; it was driven by pressure on the ground."

Source: Hansard.

Andrew Lansley says Government should have intervened over Stafford Hospital

Health questions were put in the House of Commons yesterday.

The situation at Mid Staffordshire NHS Foundation Trust, which has been slammed by the Healthcare Commission for "appalling" emergency care at Stafford Hospital, stood out. Between 2005 and 2008 about 400 more people died there than would ordinarily have been expected.

Stone MP Bill Cash expressed his profound concern:

"Mr. William Cash (Stone) (Con): Will the Secretary of State take account of the fact that I am repeating my call for an inquiry into this whole matter under the Inquiries Act 2005? Will he also make it clear that all those in that trust who are culpable, as set out in the Healthcare Commission report—that includes other senior management besides the chairman and the chief executive at the time—must be removed and not merely suspended on full pay?

Alan Johnson: As I just said, the investigation will involve everyone who has any position of authority within that trust—the whole board and all the executive directors. It will be a proper investigation and it will be fair, and the action taken will result from that inquiry, not from any knee-jerk reaction by me or anyone else."

Shadow Health Secretary Andrew Lansley (above right) went on the same topic:

"On 15 October 2007, after the terrible events at Maidstone and Tunbridge Wells NHS Trust, the Secretary of State said that

“we should be spotting these issues much earlier and getting rid of incompetent chief executives or chairpersons who, fortunately, are in the minority, rather than waiting for a report such as this, by which time, frankly, most of the damage has been done.”—[ Official Report, 15 October 2007; Vol. 464, c. 571.]

The Secretary of State knew about the failings at Stafford in May 2008, so why did he not intervene then and there?

Alan Johnson: I ask the hon. Gentleman to look at the Healthcare Commission’s report carefully. The difference between what happened in Stafford and in Maidstone and Tunbridge Wells, and the fact that the Healthcare Commission took into account those words and what others said at the time, is that as soon as commission staff went into Stafford and saw the problems—in May 2008—they immediately called the chief executive to a meeting, put their concerns to him, and started to see the process of improvement. That is the job of the Healthcare Commission while it carries out its inquiry. The staff cannot say at that stage that they have come to any conclusions, and it would be unfair, one day into an inquiry, to reach conclusions and say that heads must roll and recommendations must be made. We made that specific point to the Healthcare Commission at the time of Maidstone and Tunbridge Wells, so in Stafford staff immediately introduced measures to put things right, rather than wait for the end of the process and the report to be published—as I said they should do in that quote.

Continue reading "Andrew Lansley says Government should have intervened over Stafford Hospital" »

Health questions, including: assaults on NHS staff are rife

It was time for questions to the Health Department yesterday. Perhaps the most noteworthy question came from Mike Penning (pictured right), who spoke in light of the revelation that in 2007-08 criminal sanctions following cases of assault in the acute sector rose by thirteen per cent.

Shadow Health Secretary Andrew Lansley asked about sport in schools:

"I welcome the announcement of the Active England strategy, but it has taken a year to get there. I am afraid that the Secretary of State has got it wrong about school sports. The Government are not meeting their commitment to ensure that all pupils get two hours of sport a week in schools. In the school sport survey last October, the number of 11 to 16-year-olds getting two hours of exercise had gone down from 88 per cent. to 83 per cent. in a year. Will the Secretary of State, with his colleagues at the Department for Children, Schools and Families, ensure that the commitment to a minimum of two hours of exercise in schools is achieved, and will he tell us when will it be achieved?

Alan Johnson: From memory, the proportion of young children getting two hours of exercise in schools was about 24 per cent. when we came into government, so a drop— [ Interruption. ] Incidentally, I am not sure about the statistics that the hon. Gentleman just quoted. If there has been a slight drop, it should be seen in that context. Sport in our schools is essential to the sort of message that we seek to deliver, which is why we have pledged not just effort and time, but a huge amount of finance to meet those targets. And we will meet the target in 2010, just as I am absolutely sure we will move on to meet the extended target in 2012."

Shadow Health Minister Mark Simmonds was concerned about access to GPs:

"In Battersea, the provision of primary care is vital to the health of the community, but according to the Royal College of General Practitioners, seeing a doctor who knows the patient and their medical condition personally is important to more than 75 per cent. of patients. Yet the Secretary of State recently said that he “could not care less” which GP he sees. That is totally out of touch with patient needs both in Battersea and elsewhere. Can the Minister confirm that continuity of care is important to the vast majority of patients, particularly those with long-term conditions? If so, why are he and the Secretary of State centrally imposing polyclinics, against patients’ needs and wishes?

Mr. Bradshaw: Yes, I am happy to confirm what the hon. Gentleman asks me to confirm. However, what he says is another of the myths that were peddled by both the Opposition and the British Medical Association, at the time, in their opposition to new GP health centres. I do not know whether he has now abandoned the Conservative party’s opposition to the centres. I suspect that the Conservatives will quietly abandon that opposition, because where the new centres are opening, they are incredibly popular, not least with local Conservative councillors and Conservative MPs who want theirs to open as quickly as possible.

Of course continuity of care is important for many patients, particularly those with long-term conditions. However, many people, such as professionals who are otherwise healthy and who are juggling work and family life, find it very difficult to see their GP, because of opening times. They warmly welcome the opportunity to see a GP, and they do not particularly mind whether it is always the same GP."

It stretches credulity to say that people are indifferent about who their GP is; Mr Simmonds is correct.

Continue reading "Health questions, including: assaults on NHS staff are rife" »

Andrew Lansley criticises the government for misusing hospitals' knife wounds data

Shadow Health Secretary Andrew Lansley spoke in the House of Commons yesterday. He took Alan Johnson, his opposite number, to task over knife statistics:

"The Secretary of State will know that the NHS Information Centre provided to 10 Downing street information from hospitals about people presenting with knife wounds—data that were unpublished, not yet validated and incomplete. That was done on the basis that the information would not be used publicly in that form. Can the Secretary of State tell the House whether he knew about 10 Downing street’s intention to use those data and, whether he did or not, what steps he personally is taking to make sure that NHS data are not used for partisan purposes in that way?

Alan Johnson: I have nothing to add to the Home Secretary’s comments yesterday, particularly her apology for what happened. The hon. Gentleman has written to the Information Centre and made a number of points, all of which will be answered in due course."

To her credit, the Home Secretary did indeed apologise yesterday for what Sir Michael Scholar, head of the UK Statistics Authority called the "premature, irregular and selective release" of knife figures. Officials had pleaded with the Government not to release the statistics.

I try to avoid hyperbole on this page. So when I write that New Labour's use of statistics has been wildly irresponsible and fraudulent throughout their time in office, I hope you all know I mean it!

Tom Greeves

Andrew Lansley on health top-ups

The text of the Shadow Secretary of State for Health's speech to the Commons earlier.

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Lansley urges Government to rethink polyclinics

Opposition Day Motion:

"That this House opposes the Government’s plans to impose a polyclinic, or GP-led health centre, in every primary care trust; regrets that this could result in the closure of up to 1,700 GP surgeries; is concerned that the imposition of polyclinics against the will of patients and GPs could be detrimental to standards of care, particularly for the elderly and vulnerable, by breaking the vital GP/patient link; further regrets that these plans are being imposed without consultation; is alarmed at the prospective loss of patient access to local GP services at a time when care closer to home should be strengthened; believes that the Government’s plans would jeopardise the independence and commissioning capability of general practice in the future; supports the strengthening of access to diagnostic and therapeutic services without undermining the structure of GP services; and calls on the Government to reconsider its plans for polyclinics.

Andrew Lansley MP: "Last Thursday, the local medical committees, which are the statutory bodies required to represent GPs across the country, met in conference and passed a vote of no confidence in the Secretary of State and the policies of the Labour Government. On the same day, the British Medical Association delivered to Downing street a petition against the Government’s polyclinic proposals consisting of 1.2 million signatures. Patients care about the future of their local surgeries and about their GP services. They and GPs are concerned that the Government’s top-down, one-size-fits-all imposition of polyclinics in London and in each primary care trust across the country will reduce access to their GP services and undermine the GP-patient relationship, which is at the heart of the successful delivery of health care. Today’s motion is very simple. It urges the Government to think again. If the Government had offered additional funding to support the creation of extra GP practices in under-doctored areas, we would have supported them."

More from Hansard here.

Andrew Lansley calls for reform in family doctor services

Shadow Secretary of State for Health Andrew Lansley sets out his position on GPs in this opposition day debate:

Motion: That this House supports the family doctor service, and recognises that it is the first point of contact for the majority of patients; further recognises the invaluable role that GPs have in the NHS; regrets the undermining and undervaluing of GPs by the Government; is concerned about the lack of empirical and clinical evidence for the establishment of polyclinics in every primary care trust; opposes the central imposition of polyclinics against local health needs and requirements; is further concerned about the delay in publishing evidence on the cost-effectiveness of walk-in centres; believes that patients should be able to choose the most convenient GP practice, whether close to home or work; calls for GPs to be given real budgets, incentives to make savings, the freedom to re-invest for their patients and the ability to innovate in contracts with healthcare providers; supports rewarding GPs who choose to provide services in deprived areas or areas of expanding population; and further supports the incorporation of patient-reported outcome measures into the Quality and Outcomes framework and the development of structures and services in general practice that are designed by GPs and primary care providers in response to patients’ needs and choice.

"The purpose of the motion is straightforward. Through the new contract with general practitioners, the Government had a major opportunity to revive general practice in this country, and to rebase the NHS in patient-centred care and primary-care-led services. They failed to do that; by contrast, they have entered into a conflict with general practitioners that will undermine the service. The Government are taking an approach to the reconfiguration of primary care services that matches the dangers of the approach that they took to reconfiguration of secondary care. The progressive centralisation of services, the progressive undermining of access to care, the progressive undermining of the ability of clinicians across the NHS to determine what is best for their patients—those are the tragic consequences of the Government’s failure to negotiate the GP contract successfully. Their mean-minded approach is not to negotiate in partnership with general practitioners, but to try to arrive at a solution that cuts costs and centralises services, while undermining the independence and clinical effectiveness of general practice."

More from Hansard here.